DESCRIPTION (provided by investigator): An estimated 20-30 percent of women drug users are lesbian, bisexual or other women who have sex with women (WSWs). Contrary to theories that WSW drug users' same-sex behavior is a function of sex work or incarceration, recent ethnographic work on WSW injectors suggests that a majority of WSW drug users can be considered "sexual minorities," which we define as women for whom same-sex orientation is an important aspect of their social lives. Sexual minority status appears to affect health, health-related behaviors, and the health and drug treatment service experiences of women drug users in important ways. Additional research is needed to determine precisely how sexual minority status may complicate the health consequences of illicit drug use among women, and especially to design and evaluate interventions to reduce disparities in health between sexual minority and other drug-using women. Research of this sort, however, will first require the development of measures of sexual minority status that are valid and reliable for women drug users. This will be accomplished by: 1) increasing our understanding of the components of sexual minority status via secondary analysis of a recently-concluded ethnographic study of women lDUs in New York and Boston (which collected 260 in-depth interviews with 78 WSW subjects); 2) using these analyses to develop empirically-grounded measures of sexual minority status; and 3) preliminary validation of these measures via a pilot survey of 120 women drug users (including an estimated 24-36 sexual minorities) in New York City. The proposed study directly addresses recent recommendations by the Institute of Medicine's Committee on Lesbian Health Research Priorities that improved, multi-dimensional measures of sexual orientation be developed and applied to low-income and ethnic minority women, with specific attention to illicit drug use and its sequelae among lesbians. Towards this end, this proposed R03 study will develop measures of sexual minority status to be used in future epidemiological and health services research among women drug users.